• Director Risk Adjustment, Coding

    Highmark Health (Pittsburgh, PA)
    …submit table to CMS for reimbursement.Oversee operations to track and validate multi-pass quality review of validation leading up to external audit of Highmark ... strategy to achieve continuous improvements as it relates to Quality and Coding for the Highmark Health...as necessary; may have budgetary responsibility and authority. + Quality Improvement Specialist (QIS) Program:Vision and direction… more
    Highmark Health (08/08/25)
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  • Analyst, Coding Data Quality Auditor

    CVS Health (PA)
    …(HCC) required. + CPC (Certified Professional Coder) or CCS-P (Certified Coding Specialist -Physician) and CRC (Certified Risk Adjustment Coder) required ... all with heart, each and every day. **Position Summary** Responsible for performing quality inter-rater review audits of medical records coded by internal team… more
    CVS Health (10/02/25)
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  • Coding Audit & Education Coordinator

    St. Luke's University Health Network (Allentown, PA)
    …Certified Professional Auditor (CPMA); Certified Professional Coder (CPC); Certified); Certified Coding Specialist (CCS); In-depth knowledge of ICD CM, ICD ... be responsible for performing internal, concurrent, prospective and retrospective coding audit activities. The incumbent will also review... and validate coded medical records of the Professional Coding (PC) staff to determine data quality more
    St. Luke's University Health Network (08/20/25)
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  • DRG Specialist II

    UPMC (Pittsburgh, PA)
    …as necessary. Counsel/train coders on problems when necessary in coordination with the Coding Manager and/or Coding Specialist and assist in correcting ... and diplomatic manner required. **Licensure, Certifications, and Clearances:** + Certified Coding Specialist (CCS) OR Certified Professional Coder (CPC) OR… more
    UPMC (09/25/25)
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  • DRG Specialist

    UPMC (Pittsburgh, PA)
    …and diplomatic manner required. **Licensure, Certifications, and Clearances:** + Certified Coding Specialist (CCS) OR Certified Professional Coder (CPC) OR ... Specialist to work on inpatient auditing within our Coding Department. This position will be a work-from-home position...hours Monday through Friday. In this role, you will review clinical documentation within the medical record to ensure… more
    UPMC (10/03/25)
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  • Medical Records Technician (Clinical Documentation…

    Veterans Affairs, Veterans Health Administration (Lebanon, PA)
    …clinical staff documentation of outpatient encounters through retrospective, ideally prior to coding and billing, review of outpatient encounters and extensive ... processes in the health record to include the impact of documentation on coding , workload, quality measures, reimbursement, and funding. Provides education to… more
    Veterans Affairs, Veterans Health Administration (10/08/25)
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  • Outpatient Audit Specialist

    Datavant (Harrisburg, PA)
    …you will be instrumental in addressing consulting and educational needs related to coding quality , compliance assessments, external payer reviews, coding ... ED, Observation and I&I** **What You Will Do:** + Performs Outpatient Facility coding audits of medical records and abstracts using ICD-10-CM, CPT, HCPCS, and… more
    Datavant (09/13/25)
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  • Charge Entry Specialist -Cardiology

    St. Luke's University Health Network (East Stroudsburg, PA)
    …serve, regardless of a patient's ability to pay for health care. The Charge Review Specialist is responsible for ensuring accurate and timely revenue capture for ... entry preparation, verifying patient demographics, registering patients, verifying insurances, and coding billed diagnoses. + Perform daily review of patient… more
    St. Luke's University Health Network (08/13/25)
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  • RN Clinical Document Specialist - AHN

    Highmark Health (Harrisburg, PA)
    …+ Excellent communication skills + Critical thinking skills + Certified Coding Specialist (CCS) + Certified Outpatient Clinical Documentation Improvement ... Network **Job Description :** **GENERAL OVERVIEW:** Improves the overall quality and completeness of medical documentation; facilitates enhancements to clinical… more
    Highmark Health (10/04/25)
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  • Inpatient Audit Specialist

    Datavant (Harrisburg, PA)
    …you will be instrumental in addressing consulting and educational needs related to coding quality , compliance assessments, external payer reviews, coding ... Academic/Trauma Level 1 facility. **What You Will Do:** + Performs Inpatient Facility coding audits according to scope of work, for the purpose of Onboarding,… more
    Datavant (07/29/25)
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